BACKGROUND: Bicondylar tibial plateau fractures are often associated with severe soft tissue injuries that can frequently result in compartment syndrome and are frequently open fractures. Operative management of these injuries is invariably complicated by the condition of the soft tissue envelope of the proximal tibia. METHODS: Between July 2008 and March 2009, 13 consecutive patients who sustained bicondylar tibial plateau fractures were treated with Ilizarov fine wire circular external fixators. These 13 patients were reviewed with regard to their functional outcome and any complications incurred during the management period. RESULTS: Eleven patients met the inclusion and exclusion criteria. All patients achieved bony union and had good functional results without serious complications. No osteomyelitis, septic arthritis, loss of reduction or wound dehiscence occurred. Superficial pin tract infection was the most common complication encountered, but in all cases pin site care and oral antibiotics were sufficient to eradicate the problem and no pins or wires needed to be removed or resited. CONCLUSION: The treatment of bicondylar tibial plateau fractures with the Ilizarov circular external fixator is safe and effective, and produces good functional results without serious complications.